How much rates vary
Facilitymedian $2,188 · 10th to 90th $776 to $7,244Professionalmedian $661 · 10th to 90th $102 to $1,000
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $831.76 Median $10,964.78 Typical High $21,877.62 | Facility | None | $831.76 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $831.76 | Professional | None | $707.95 | $831.76 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $6,918.31 | Facility | None | $1,047.13 | $2,454.71 | $6,918.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $912.01 | Professional | None | $645.65 | $691.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,290.87 Typical High $3,235.94 | Facility | None | $630.96 | $2,290.87 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,288.25 | Professional | None | $776.25 | $812.83 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $831.76 Typical High $2,089.30 | Facility | None | $724.44 | $831.76 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $1,096.48 | Professional | None | $794.33 | $831.76 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $549.54 Typical High $912.01 | Professional | None | $79.43 | $549.54 | $912.01 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,174.90 | Professional | None | $562.34 | $724.44 | $1,174.90 |
11 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $354.81 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $575.44 | $575.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $512.86 Typical High $645.65 | Professional | 51 · Multiple procedures | $398.11 | $512.86 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $208.93 Typical High $257.04 | Professional | 80 · Assistant surgeon | $158.49 | $208.93 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $144.54 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $112.20 | $144.54 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $144.54 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $144.54 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $144.54 Typical High $181.97 | Professional | AS · PA/NP assist | $112.20 | $144.54 | $181.97 |
Where South Carolina sits
The same service costs 4.4 times more in Alaska than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $7,120DE $1,631
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.